Different Types of Acne Classifications

Understanding acne classification is a useful tool when treating acne.

It can help you to evaluate your level of acne and the inflammation within your skin.



This type of acne is often associated with the following skin conditions:

Papules: These are best described as lesions on the surface of the skin.

They are often small and red in shape and are not always visible to the naked eye.

Pustules: Unlike papules, these are raised and dome shaped making them more obvious.

Debris in the form of bacteria, white blood cells and dead skin cells build up at the root of the hair follicle, this creates pus which causes inflammation and redness.

If you can get your acne under control at this stage it can be treated effectively, and none of these will turn into painful nodules or cysts, treated early enough, it will also eliminate any chance of scarring.

Acne Vulgaris: This condition presents itself as irregular shaped lesions that reside deep in the dermis.

Cysts are also apparent, characterised as deep and painful lesions filled with pus.

Often there is a temptation to squeeze these cysts, but this should be resisted, as it can cause deeper infection and scarring.


This type of acne, can be improved when the P. Acnes bacteria is reduced in the follicle, this is often achieved through the use of antibiotics.

The only problem with this, is trying to deliver antibiotics to an oil rich environment that has been created by the sebaceous glands.


To deal with this a three pronged approach is required:

  1. Topical antibiotics
  2. Oral antibiotics
  3. Topical ingredients that contain antimicrobial properties

Benzoyl Peroxide is a good example of a topical ingredient found in skin care, that is useful in suppressing P Acnes bacteria, this is due to its effectiveness in penetrating the oil rich follicle.

However, it is important to note that if you are suffering from sensitisation, Benzoyl Peroxide can cause inflammation and irritation in the skin in some instances.

Clindamycin and Erythromycin combined; work really well on Acne Vulgaris and as a hormonal acne treatment, helping to reduce inflammation in the lesions.

Extensive research has been carried out on Essential oils especially Tea Tree, which is considered to be one of the best natural treatments for acne.

This is something I discussed in the article how to get rid of acne with Essential oils, studies have found, that Tea Tree has exactly the same effect on the skin as Benzoyl Peroxide, but without the irritation.

So it may be worth considering this natural route, if your skin is particularly prone to sensitivity.

In my clinic I often prescribe Azelaic Acid to my clients, as I find this is an extremely effective natural, topical treatment.

It has great results in helping to reduce P. Acnes, as well as having mild anti comedogenic and anti inflammatory activity on the skin.

It is also beneficial in helping to suppress any post-hyper pigmentation, which may occur in individuals who have a darker complexion.


Acne Conglobata: This is a chronic form of acne, where a lot appears to be going on within the skin:

  • Abscess
  • Large dome shaped lesions
  • Painful pus filled cysts that have difficulty healing
  • Black heads and white heads on the  T. Zone

This is why it is such a difficult and controversial skin condition to treat.

This form of acne can also present itself on the arms, back, chest, neck and upper thighs…..

It can do untold damage in the form of acne scars if not treated early enough.

Acne Fulminan: This acne comes on abruptly, in the form of acute inflammation that can cause ulceration.

 It occurs as inflammation and aching of the joints, often coupled with a fever.

Gram-Negative Folliculitis: This is an acne disorder caused by a bacterial infection, which occurs as a result of a complications in clients, who have previously been suffering from Acne Vulgaris or Rosacea.

One of the causes of this type of acne, may be due to ineffective antibiotic treatment.


I find that chronic acne, rarely responds well to any form of antibiotics or topical treatments.

However as a last resort, accutane is going to be the best prescription medication, which is a derivative of Vitamin A.

This treatment has a number of beneficial effects, including helping to reduce the amount of oil produced in the skin.

Which in turn reduces the amount of P. Acnes bacteria that reside in the pores of the skin.

Accutane also slows down cellular turnover, thus preventing the dead skin cells and debris from clogging the pores.

Often severe cases of acne don’t respond well to treatment, so an aggressive approach to treatment may be required.

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